Within a number range (e.g., 12–18), a dash (–) should be read as “through.”

Vaccine doses administered ≤4 days before the minimum age or interval are considered valid. Doses of any vaccine administered ≥5 days earlier than the minimum age or minimum interval should not be counted as valid and should be repeated as age-appropriate. The repeat dose should be spaced after the invalid dose by the recommended minimum interval. For further details, see Table 3-1, Recommended and minimum ages and intervals between vaccine doses, in General Best Practice Guidelines for Immunization.

For vaccination of persons with immunodeficiencies, see Table 8-1, Vaccination of persons with primary and secondary immunodeficiencies, in General Best Practice Guidelines for Immunization, and Immunization in Special Clinical Circumstances (In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2015 report of the Committee on Infectious Diseases. 31st ed. Elk Grove Village, IL: American Academy of Pediatrics, 2018:67–111).

For information regarding vaccination in the setting of a vaccine-preventable disease outbreak, contact your state or local health department.

The National Vaccine Injury Compensation Program (VICP) is a no-fault alternative to the traditional legal system for resolving vaccine injury claims. All routine child and adolescent vaccines are covered by VICP except for pneumococcal polysaccharide vaccine (PPSV23). For more information, see www.hrsa.gov/vaccinecompensation/index.htmlExternal
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Routine vaccination

2-dose series (Havrix 6–12 months apart or Vaqta 6–18 months apart, minimum interval 6 months); a series begun before the 2nd birthday should be completed even if the child turns 2 before the second dose is administered.

Catch-up vaccination

Anyone 2 years of age or older may receive HepA vaccine if desired. Minimum interval between doses: 6 months

Adolescents 18 years and older may receive the combined HepA and HepB vaccine, Twinrix, as a 3-dose series (0, 1, and 6 months) or 4-dose series (0, 7, and 21–30 days, followed by a dose at 12 months).

International travel

Persons traveling to or working in countries with high or intermediate endemic hepatitis A:

Infants age 6–11 months: 1 dose before departure; revaccinate with 2 doses, separated by 6–18 months, between 12 to 23 months of age

Unvaccinated age 12 months and older: 1st dose as soon as travel considered

Special situations

At risk for hepatitis A infection: 2-dose series as above

Chronic liver disease

Clotting factor disorders

Men who have sex with men

Injection or non-injection drug use

Homelessness

Work with hepatitis A virus in research laboratory or nonhuman primates with hepatitis A infection

Travel in countries with high or intermediate endemic hepatitis A

Close, personal contact with international adoptee (e.g., household or regular babysitting) in first 60 days after arrival from country with high or intermediate endemic hepatitis A (administer dose 1 as soon as adoption is planned, at least 2 weeks before adoptee’s arrival)

Catch-up vaccination

Unvaccinated persons should complete a 3-dose series at 0, 1–2, 6 months.

Adolescents age 11–15 years may use an alternative 2-dose schedule with at least 4 months between doses (adult formulation Recombivax HB only).

Adolescents 18 years and older may receive a 2-dose series of HepB (Heplisav-B) at least 4 weeks apart.

Adolescents 18 years and older may receive the combined HepA and HepB vaccine, Twinrix, as a 3-dose series (0, 1, and 6 months) or 4-dose series (0, 7, and 21–30 days, followed by a dose at 12 months).

Inactivated poliovirus vaccination (minimum age: 6 weeks)

Routine vaccination

4-dose series at ages 2, 4, 6–18 months, 4–6 years; administer the final dose on or after the 4th birthday and at least 6 months after the previous dose.

4 or more doses of IPV can be administered before the 4th birthday when a combination vaccine containing IPV is used. However, a dose is still recommended after the 4th birthday and at least 6 months after the previous dose.

Catch-up vaccination

In the first 6 months of life, use minimum ages and intervals only for travel to a polio-endemic region or during an outbreak.

IPV is not routinely recommended for U.S. residents 18 years and older.

Routine vaccination

1 dose any influenza vaccine appropriate for age and health status annually (2 doses separated by at least 4 weeks for children 6 months–8 years who did not receive at least 2 doses of influenza vaccine before July 1, 2018)

Special situations

Egg allergy more severe than hives (e.g., angioedema, respiratory distress): Any influenza vaccine appropriate for age and health status annually in medical setting under supervision of health care provider who can recognize and manage severe allergic conditions

LAIV should not be used for those with a history of severe allergic reaction to any component of the vaccine (excluding egg) or to a previous dose of any influenza vaccine, children and adolescents receiving concomitant aspirin or salicylate-containing medications, children age 2 through 4 years with a history of asthma or wheezing, those who are immunocompromised due to any cause (including immunosuppression caused by medications and HIV infection), anatomic and functional asplenia, cochlear implants, cerebrospinal fluid-oropharyngeal communication, close contacts and caregivers of severely immunosuppressed persons who require a protected environment, pregnancy, and persons who have received influenza antiviral medications within the previous 48 hours.

Menactra must be administered at least 4 weeks after completion of PCV13 series.

Travel in countries with hyperendemic or epidemic meningococcal disease, including countries in the African meningitis belt or during the Hajj:

Children age less than 24 months:

Menveo (age 2–23 months):

Dose 1 at 8 weeks: 4-dose series at 2, 4, 6, 12 months

Dose 1 at 7–23 months: 2-dose series (dose 2 at least 12 weeks after dose 1 and after the 1st birthday)

Menactra (age 9–23 months):

2-dose series (dose 2 at least 12 weeks after dose 1; dose 2 may be administered as early as 8 weeks after dose 1 in travelers)

Children age 2 years or older: 1 dose Menveo or Menactra

First-year college students who live in residential housing (if not previously vaccinated at age 16 years or older) or military recruits: 1 dose of Menveo or Menactra

Note: Menactra should be administered either before or at the same time as DTaP. For MenACWY booster dose
recommendations for groups listed under “Special situations” above and additional meningococcal vaccination information, see meningococcal MMWR publications.